Q: ResMed CPAP S9 AutoSet vs. VPAP ST ???

[Peter_C]

Having said that I started with a straight cpap pressure of 18, and when I bought my own machine I bought a BiPAP Auto.

Based on American Academy of Sleep Medicine (AASM) titration protocol criteria, switch to bi-level if patient cannot tolerate pressure increase or pressure threshold of 15 cmH2O is reached

Zonk beat me to it. In the 'old days' (when all machines were bricks), those were the primary reasons to switch a patient to a bi-level (Vpap, biLevel, bipap, etc).

NOTE: You are only on the higher pressure during 'inhale' only, so ex-hale, pauses, etc, you're on the lower pressure.

BiLevel machine were also tried to limit 'centrals'.

Now, there are machines that do both different things, and in different ways. It used to be, that brand wasn't much of an issue, as all the brands did everything the same way-Now that is no longer true.

We all want the *best*. But on a new patient, the 'best' depends on your 'sleep study'.

One last point? Historically, CPAPs were always the first choice as for many patients a bi-level is hard to get used to.

[justMongo]

So here's der goldene Scheißhaufen.

If you have significant central apnea (CA) where your brain does not tell your lungs to breathe, you many need an ASV machine.
(Auto Servo Ventilator). In another thread, you asked about the timed backup rate in a VPAP ST machine. That's an attempt to solve mild CA by forcing IPAP when the patient doesn't cause a spontaneous (S) switch to IPAP by inhaling.

Some people get run through a series of machines by a broken medical system before finding what they really need.
Others have to take a stab at it because they live in a first world Nation with a 3rd world health system... that will be the US in a few years!

[dubli]

Thank you for all the helpful info, it's appreciated.

Made a few notes, very interesting.

Thanks

[PaulaO2]

So the VPAP ST isn't an auto? All those bells and whistles but only one note? How...silly.

[vsheline]

Wondering, in your opinion, which is a better machine (for more comfortable use) out of the...
- ResMed CPAP S9 AutoSet
and the
- ResMed VPAP ST (from S9 series)
???

Which would be more comfortable to wear?

If I have to chose out of Bipap and Auto-adjusting - which is better/more important??

Which is newer model?

Which is better overall?

If you have significant central apnea (CA) where your brain does not tell your lungs to breathe, you many need an ASV machine.
(Auto Servo Ventilator). In another thread, you asked about the timed backup rate in a VPAP ST machine. That's an attempt to solve mild CA by forcing IPAP when the patient doesn't cause a spontaneous (S) switch to IPAP by inhaling.

Hi dubli,

As justMongpo pointed out, the ResMed VPAP ST has a backup rate, meaning it will cycle back and forth between a lower EPAP pressure (for exhalation) and a higher IPAP pressure (for inhalation), even if the patient is in the middle of a central or obstructive apnea and has stropped breathing. Whether the reason you have stopped breathing is central or obstructive, the machine will try to help you breathe after just a few seconds of waiting for you to breathe on your own.

The ASV machines (like PhillisBalboa and I have) do this also, except the ASV machines can also INCREASE the amount of Pressure Support as much as may be needed to keep us breathing our normal amount. With an ST machine, there is an automatic backup rate but no automatic adjustment of EPAP and no automatic adjustment of PS, and the PS often is only high enough to keep us partially ventilated if we completely halt all breathing effort. The VPAP ST machine is in the same class of machines as ASV machines, meaning it is just as difficult to get insurance to cover one as the other.

The standard VPAP machine is the VPAP S (not VPAP ST), which has no backup rate and has fixed (manually adjusted) EPAP and fixed PS. Bi-level machines without a backup rate are in a lower class of machines than the ones with a backup rate, meaning it's easer to get insurance to cover the standard VPAP machines. Like all machines which do not have a backup rate, if we are in the middle of an apnea the machine will do nothing to interrupt the apnea.

The auto-adjusting VPAP Auto has no backup rate and has fixed PS but does auto-adjust EPAP to avoid obstructive conditions like obstructive apneas, hypopneas, Flow Limitation and Snore. It is in the same insurance classification as the non-auto standard VPAP machines.

The Philips Respironics BiPAP Auto has more features than the ResMed VPAP Auto. It can (very slowly) adjust PS every few minutes a little higher and lower, to see if a higher or lower amount of PS would be better. It also has Flex, which is an additional type of exhalation relief. But I think most who have compared the two machines have reported the PRS1 BiPAP Auto is louder than the S9 VPAP Auto, when both machines are operating at same pressure.

The auto-adjusting ResMed AutoSet has no backup rate and has fixed EPR up to 3 (EPR is much like PS except is limited to a range of 0 to 3 cm H20) and does auto-adjust EPAP to avoid obstructive conditions like obstructive apneas, hypopneas, Flow Limitation and Snore. It is in the lowest insurance classification, along with standard non-adjusting CPAP machines. Fixed CPAP and auto-titrating APAP machines are the easiest class of machines to get health insurance to pay for, but the equipment providers may try to provide only the cheapest machines, since profit margins are much higher on non-auto machines and on machines without full data recording.

Machine choices:
http://www.apneaboard.com/wiki/index.php...ne_Choices

[dubli]

[Frieda]

For some reason Sleepyhead recognized the mode of my Autoset as VPAP-S/T a couple nights back.